Mental health care in jail is deficient for both inmates and the jail administration. Out on the streets, the mentally ill present themselves at times as dangerous, or maybe just as an annoyance and an unseemly part of the cities they inhabit. Many towns and cities have good intentions to “clean up” their locality, but to sweep this problem under the proverbial rug will not take care of the mentally ill or keep costs down for the county. Mental health community centers across the country are seeing cuts in their budgets which will see programs lose funding for the homeless.
For many communities, the mentally ill are not able to be housed in traditional homeless shelters, as they are not able to follow rules and regulations put in place to keep residents safe. These shelters are largely subsidized by donations made by the community and volunteers. In order to maintain a decent living environment, the workers are unable to oversee the mentally ill, and they are typically not trained to do so.
Mental health care in jails is deficient for most jail inmates. There are those who can be quite docile, but much of the work done by caretakers is simply to maintain order and keep the prisoners safe.
Nowadays, jails serve as housing for mentally ill patients who have been picked up by the authorities for vagrancy, public intoxication, disruptive behaviors and sometimes, for actual crimes. Although jails may have a section dedicated to inmates that suffer from mental illness, with a team of mental health professionals, the most they can do is medicate and maintain.
Those who are more docile usually get more rewards in the living space and recreation rooms reserved for those who can mind their manners. TV is a good example of how those with less severe mental illness are entertained. In Cook County, Illinois, Division 2 across from the psych ward takes inmates who are willing to eat, shower, dress and sit calmly. In one room, there is a TV, which inmates stand by, while 40 or so others mill about a row of bunks. Three of them say they came to the county jail to get back on their medication after their local clinic closed. It is an assurance for some that they can get prescribed medicines while incarcerated.
It takes a trip to the past to remember how the mentally ill were treated in institutions. In some private, but mostly state-run institutions, the mentally ill were housed and medicated. Since the late 1960s, institutions have been viewed as “cuckoo’s nests” and as substandard facilities where the caretakers were just as mad as the patients. The label given to these institutions were sometimes with merit, but the baby was thrown out with the bath water when all the institutions closed, and mental patients “mainstreamed” into their communities.
Thirty years ago, then-President Reagan completed the mainstream movement by not approving the bill that would have put money into mental institutions and services. In this act, the closing of institutions followed, and mentally ill persons were given their freedom. Unfortunately, these patients did not always like to take their prescribed medicines, so the lack of structure left a big gap in services for the mentally ill and those who lived around them.
Mental health care is deficient in the jail system. A different approach to mental health care will need to be addressed in the near future, if the mentally ill are to be served properly in their communities.
By Lisa M Pickering